Deborah J. Aaron

Longitudinal changes in physical activity in a biracial cohort during adolescence

PURPOSE This report describes the development and use of two self-report methods and an objective measure to assess longitudinal changes in physical activity in a large biethnic cohort of young girls from childhood through adolescence. METHODS The NHLBI Growth and Health Study (NGHS) is a multicenter study of obesity development in 2379 black and white girls followed from ages 9-10 yr to 18-19 yr (NGHS years 1-10). A Caltrac activity monitor was used to objectively quantify activity levels in years 3-5. A 3-d diary (AD) and a habitual patterns questionnaire (HAQ) were administered annually and biannually, respectively, to subjectively quantify physical activity levels. The changing pattern of activities as the girls matured during the 10-yr study period necessitated periodic form changes. Empirical analytic approaches were developed to help distinguish between true longitudinal changes in activity levels from potential numerical artifacts resulting from modifications in forms. RESULTS The longitudinal activity data indicate a steep decline in the level of reported activity from baseline to year 10 as indicated by AD scores (446.8 to 292.1 MET-min x d(-1), 35%) as well as by HAQ scores (29.3 to 4.9 MET-times x wk(-1), 83%). This parallel trend in the pattern of the decline in activity among the two self-report methods was mirrored by a similar decline using the Caltrac method of physical activity assessment. From years 3 to 5, the AD decreased by 22%, whereas both the HAQ and Caltrac declined by 21%. CONCLUSION The longitudinal data on physical activity collected in the NGHS cohort further confirm a dramatic decrease in the overall level of physical activity during the transition from childhood to adolescence. The consistency among the three methods indicate that both the AD and HAQ are useful tools for the assessment of activity levels in adolescent girls.

The epidemiology of low back pain in an adolescent population.

We assessed the prevalence of low back pain (LBP) in a cohort of 1242 adolescents (aged 11 through 17) currently participating in a 4-year prospective study of medically treated injuries. Overall, 30.4% of the adolescents reported LBP. The impact of LBP in adolescents was considerable, with one third resulting in restricted activity and 7.3% seeking medical attention. Life-table analysis demonstrated that by age 15, the prevalence of LBP increased to 36%. There were few differences by gender or race. These results suggest that LBP in adolescents is a serious public health problem.

The epidemiology of leisure physical activity in an adolescent population.

A cohort of 1245 adolescents, 12-16 yr old and participating in a prospective study of risk factors for injury, were surveyed annually to assess past year leisure physical activity. This report describes the development and reproducibility of the questionnaire and provides the descriptive epidemiology of leisure physical activity in adolescents. The questionnaire was self-administered twice, a year apart, and had a 1 yr test-retest rank order correlation of 0.55. The past year estimate of leisure activity was also shown to be related to fitness (rho = -0.37), which was defined as the time needed to complete a 1-mile run. Males reported significantly more activity than females (P < 0.05) and whites reported more activity than nonwhites (P < 0.05). However, socioeconomic status was not found to be a determinant of activity levels in either males or females. In females, a negative association between activity and age was found (P < 0.05); however, this association was not evident in males. In summary, an activity questionnaire has been developed and was shown to be both reproducible and feasible. Therefore, it was used to examine habitual leisure physical activity patterns of adolescents.

Physical activity and the initiation of high-risk health behaviors in adolescents.

The association of physical activity to the initiation of health risk behaviors was examined in a 3-yr prospective study of a population-based cohort of 1245 adolescents aged 12-16 yr. Four hundred thirty-seven students (35% of the cohort) were identified at baseline via self-report survey as never having smoked cigarettes, consumed alcohol, used marijuana, or carried a weapon. Three measures of physical activity were obtained at baseline: leisure-time physical activity (LTPA), level of aerobic fitness (AF), and participation in competitive athletics. Significant associations, with notable gender differences, were observed between physical activity and the initiation of cigarette smoking and alcohol use. The cumulative proportion of male students initiating alcohol use was 48%, 42%, and 24% for high, moderate, and low LTPA, respectively (P < 0.01). Males who participated in competitive athletics were significantly more likely than nonathletes to initiate alcohol use (44% vs 17%, P < 0.01). The cumulative proportion of female students initiating cigarette use was 10%, 23%, and 22% for high, moderate, and low LTPA, respectively (P < 0.05) and 7%, 28%, and 16% for high, moderate, and low AF, respectively (P < 0.05). No association was found between physical activity and weapon carrying. These results indicate that in this cohort of adolescents, the most active or most fit females were less likely to initiate cigarette smoking. In contrast, the most active males or males who participated in competitive athletics appeared more at-risk for initiating alcohol consumption than their less active counterparts.

Association of Childhood Sexual Abuse With Obesity in a Community Sample of Lesbians

Objective: Our goal was to examine the association between childhood sexual abuse (CSA) and obesity in a community‐based sample of self‐identified lesbians.

Estimating the lesbian population: a capture-recapture approach

Study objective: Little is known about the number of women who identify as lesbian. Estimates from the US range from 1% to nearly 10%. Accurate estimates are critical in order to meet lesbian’s healthcare needs and to address health problems that may be more prevalent among them. This study used capture-recapture methods to estimate the lesbian population of Allegheny County, Pennsylvania. Design: Mailing lists from four sources were used to identify lesbians. The capture-recapture method and log-linear modelling were used to estimate the number of lesbians in the defined geographical area, and the percentage of the female population they comprised there was determined through census data. Setting: Allegheny County, Pennsylvania, USA. Results: A total of 2185 unique names were identified. The capture-recapture method estimated that the total lesbian population of Allegheny County was 7031 (95% CI 5850 to 8576). Therefore, based on the 1990 census figures, the county’s adult lesbian population was estimated to be 1.87% (95% CI 1.56% to 2.28%) of the adult female population. Conclusions: An estimate of the lesbian population is fundamental for addressing lesbian’s health needs and for developing appropriate research programmes. Capture-recapture methods have the potential to provide accurate and reliable estimates of this population in any location.

One repetition maximum prediction models for children using the OMNI RPE Scale.

This investigation developed statistical models to estimate one repetition maximum (1 RM) muscular strength using submaximal ratings of perceived exertion (RPE) as predictor variables. Ten- to 14-year-old girls (n = 35) and boys (n = 35) performed two sets (10 repetitions) of biceps curl (BC) and knee extension (KE) exercise using weights approximating 30% and 50% 1 RM. RPE was assessed during the final repetition of each set using the childrens OMNI Resistance Exercise Scale (0-10). Sex-specific statistical models predicted 1 RM using RPE derived from both sets of BC and KE exercises. For both girls and boys, RPE ranged from 3.7 to 6.6 for BC and 4.1 to 7.2 for KE. Group mean 1 RM was (a) girls: BC, 7.44 kg, KE, 13.25 kg and (b) boys: BC, 9.19 kg, KE, 16.24 kg. One repetition maximum prediction models for girls were significant (P < 0.01) for BC (r = 0.87) and KE (r = 0.89). One repetition maximum prediction models for boys were significant (P < 0.01) for BC (r = 0.89) and KE (r = 0.87). The RPE predictors were practical and accurate measures, making the 1 RM models potentially applicable when assessing large numbers of children in short time periods.

Barriers to Moderate Physical Activity in Adult Lesbians

ABSTRACT Adult lesbians are not sufficiently physically active to achieve physical and psychological health benefits. Lesbians are one of the least understood minority groups. Therefore, the purpose of this study was to use an ecological framework to identify factors internal to individuals and present in their social environments that may impede participation in regular physical activity. Twenty-one self-identified lesbians aged 22 to 61 years participated in one of four focus groups. The lesbian participants reported many general barriers (i.e., obstacles to participation regardless of sexual orientation) similar to previous research with other populations of women, not stratified by sexual orientation, such as being too tired and the lack of a physical activity partner. A number of lesbian-specific barriers (i.e., obstacles unique to being a lesbian) were also identified, such as the lack of lesbian-focused physical activity groups and the lack of same-sex family memberships to fitness facilities. In conclusion, for many of the general barriers, some of the proven and effective traditional intervention strategies are likely to be effective in increasing physical activity participation rates in the lesbian population. However, barriers related to sexual orientation are likely deeply entrenched in the socio-cultural system of American society and require a societal rethinking of attitudes towards lesbians, a cultural change that is not as easily amenable to traditional health promotion interventions.

Comparison of maximal oxygen consumption between black and white prepubertal and pubertal children.

The purpose of this investigation was to determine whether maximal oxygen consumption (VO2max) differed between two selected groups of black and white children and whether a difference existed to determine whether it was related to hematologic profiles, body composition, and/or physical activity/inactivity level. Forty-five prepubertal and 42 pubertal, clinically normal black and white children participated. Dual-energy x-ray absorptiometry was used to determine body composition. A computed tomography scan of the abdomen was used to determine visceral adipose tissue and s.c. adipose tissue. Daily physical activity/inactivity was assessed by questionnaire. Black prepubertal and pubertal children had lower VO2max values when compared with white children (28.8 ± 7.8 versus 35.0 ± 6.5 mL · kg−1 · min−1, p < 0.01; 33.7 ± 6.4 versus 40.4 ± 10.2 mL · kg−1 · min−1, p < 0.05; respectively). Black prepubertal and pubertal children had lower Hb concentrations ([Hb]) and hematocrits than white children (prepubertal: 12.1 ± 0.5 versus 12.8 ± 0.9 g/dL, p < 0.001; 35.6 ± 1.4 versus 37.4 ± 2.3%, p < 0.01, respectively; pubertal: 13.0 ± 0.9 versus 13.6 ± 0.7 g/dL, p < 0.05; 37.7 ± 2.5 versus 39.5 ± 2.1%, p < 0.05, respectively). In conclusion, these findings indicate that black prepubertal and pubertal children had lower VO2max when compared with their white peers matched for age, pubertal stage, and body mass index. This difference in VO2max could be attributed at least in part to comparatively lower [Hb] and more sedentary lifestyle in the black children. Further investigations should study Hb flow rate (a function of [Hb] × maximal cardiac output) in black and white children as it relates to VO2max.

Comparison of Maximal Oxygen Consumption between Obese Black and White Adolescents

Abstract The purpose of this investigation was to determine whether maximal oxygen consumption (VO2max) differed between clinically obese black and white children and if a difference existed to determine whether it was related to hematological profiles and/or physical activity/inactivity levels. Twenty-three black and 21 white adolescents were matched for age, BMI, and Tanner stage (II-V). Body composition was determined by DEXA and CT scan. Daily physical activity/inactivity was assessed by questionnaire. VO2max was assessed using the Bruce treadmill protocol. Black participants had significantly lower VO2max and VO2maxFFM values when compared with white adolescents (26.1 ± 4.2 versus 29.9 ± 3.1 mL · kg−1 · min−1; 48.3 ± 8.8 versus 55.6 ± 5.2 mL · kgFFM−1 · min−1, respectively). Black adolescents also had significantly lower Hb concentrations ([Hb]) than white children (12.7 ± 1.3 versus 13.4 ± 0.7 g/dL). Black adolescents were more physically inactive than their white peers. VO2max correlated with [Hb] for the combined groups. Obese black adolescents had lower VO2max compared with white children and this difference was explained, in part, by the lower [Hb] observed in the black participants. Further investigations should study Hb flow rate (a function of [Hb] · maximal cardiac output) and physical activity/inactivity patterns in obese black and white children as it relates to VO2max.